Provider Demographics
NPI:1871809210
Name:SALVADRAS, JUDY M (N/A)
Entity type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:M
Last Name:SALVADRAS
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25905 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764-6326
Mailing Address - Country:US
Mailing Address - Phone:225-659-2913
Mailing Address - Fax:225-659-2913
Practice Address - Street 1:25905 WINTER ST
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764-6326
Practice Address - Country:US
Practice Address - Phone:225-659-2913
Practice Address - Fax:225-659-2913
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-23
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies